• 1.

    Salomez F, Vincent JL. Submersion: a review of epidemiology, pathology, treatment and prevention. Resuscitation 2004;63:251268.

  • 2.

    Olshaker JS. Submersion. Emerg Med Clin North Am 2004;22:357367.

  • 3.

    Spicer TS, Quinn D, Nyi Nyi NN, et al. Acute renal impairment after immersion and near-drowning. J Am Soc Nephrol 1999;10:382386.

  • 4.

    Ender PT, Dolan MJ. Pneumonia associated with near-drowning. Clin Infect Dis 1997;25:896907.

  • 5.

    Haddy TB, Disenhouse RB. Acute pulmonary edema due to neardrowning in fresh water; case report. J Pediatr 1954;44:565569.

  • 6.

    Bonnor R, Siddiqui M, Ahuja TS. Rhabodomyolysis associated with near-drowning. Am J Med Sci 1999;318:201202.

  • 7.

    Modell JH, Davis JH. Electrolyte changes in human drowning victims. Anesthesiology 1969;30:414420.

  • 8.

    Hwang V, Shofer FS, Durbin DR, et al. Prevalence of traumatic injuries in drowning and near drowning in children and adolescents. Arch Pediatr Adolesc Med 2003;157:5053.

    • Search Google Scholar
    • Export Citation
  • 9.

    Munro HM, Thrusfield MV. “Battered pets”: features that raise suspicion of non-accidental injury. J Small Anim Pract 2001;42:218226.

    • Search Google Scholar
    • Export Citation
  • 10.

    Humber KA. Near drowning of a gelding. J Am Vet Med Assoc 1988;192:377378.

  • 11.

    Olby N, Harris T, Burr J, et al. Cerebellar cortical degeneration in adult American Staffordshire Terriers. J Vet Intern Med 2004;18:201208.

    • Search Google Scholar
    • Export Citation
  • 12.

    Conn AW, Miyasaka K, Katayama M, et al. A canine study of cold water drowning in fresh versus salt water. Crit Care Med 1995;23:20292037.

    • Search Google Scholar
    • Export Citation
  • 13.

    Byard RW, Cains G, Simpson E, et al. Drowning, haemodilution, haemolysis and staining of the intima of the aortic root—preliminary observations. J Clin Forensic Med 2006;13:121124.

    • Search Google Scholar
    • Export Citation
  • 14.

    Orlowski JP, Abulleil MM, Phillips JM. The hemodynamic and cardiovascular effect of near-drowning in hypotonic, isotonic, or hypertonic solutions. Ann Emerg Med 1989;18:10441049.

    • Search Google Scholar
    • Export Citation
  • 15.

    Fiser DH. Near-drowning. Pediatr Rev 1993;14:148151.

  • 16.

    Gonzalez-Rothi RJ. Near-drowning: consensus and controversies in pulmonary and cerebral resuscitation. Heart Lung 1987;16:474482.

  • 17.

    Modell JH, Graves SA, Ketover A. Clinical course of 91 consecutive near-drowning victims. Chest 1976;70:231238.

  • 18.

    Oakes DD, Sherck JP, Maloney JR, et al. Prognosis and management of victims of near-drowning. J Trauma 1982;22:544549.

  • 19.

    van Berkel M, Bierens JJ, Lie RL, et al. Pulmonary oedema, pneumonia and mortality in submersion victims; a retrospective study in 125 patients. Intensive Care Med 1996;22:101107.

    • Search Google Scholar
    • Export Citation
  • 20.

    Morley PS, Apley MD, Besser T, et al. Antimicrobial drug use in veterinary medicine. J Vet Intern Med 2005;19:617629.

  • 21.

    Calderwood HW, Modell JH, Ruiz BC. The ineffectiveness of steroid therapy for treatment of fresh-water near-drowning. Anesthesiology 1975;43:642650.

    • Search Google Scholar
    • Export Citation
  • 22.

    Hypothermia after Cardiac Arrest Study Group. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 2002;346:549556.

    • Search Google Scholar
    • Export Citation
  • 23.

    Suominen P, Baillie C, Korpela R, et al. Impact of age, submersion time and water temperature on outcome in near-drowning. Resuscitation 2002;52:247254.

    • Search Google Scholar
    • Export Citation
  • 24.

    Thompson DC, Rivara FP. Pool fencing for preventing drowning in children. Cochrane Database Syst Rev 2000;2:CD001047.

  • 25.

    Isben LM, Koch T. Submersion and asphyxial injury. Crit Care Med 2002;30:S402S408.


Evaluation of freshwater submersion in small animals: 28 cases (1996–2006)

Geoff G. Heffner DVM1, Elizabeth A. Rozanski DVM, DACVECC, DACVIM2, Matthew W. Beal DVM, DACVECC3, Søren Boysen DVM, DACVECC4, Lisa Powell DVM, DACVECC5, and Sophie Adamantos BVSc, DACVECC, MRCVS6
View More View Less
  • 1 Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.
  • | 2 Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.
  • | 3 Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824.
  • | 4 Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Québec, QC J2S 2M2, Canada.
  • | 5 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108.
  • | 6 Emergency and Critical Care Service, The Royal Veterinary College, University of London, London, NW1 0TU, England.


Objective—To determine clinical characteristics, treatments, and outcome in dogs and cats evaluated after submersion in freshwater.

Design—Retrospective case series.

Animals—25 dogs and 3 cats.

Procedures—Medical records were reviewed for signalment; causes, location, and month of submersion; physical examination findings at admission; results of blood gas analysis; treatments administered; duration of hospitalization; and outcome, including evidence of organ failure or compromise.

Results—All submersions involved bodies of freshwater. Fourteen animals were submerged in man-made water sources, 13 were submerged in natural water sources, and the body of water was not recorded in 1 case. Twenty (71%) submersions occurred from May through September. Cause was identified in 16 animals and included extraordinary circumstances (n = 6), falling into water (5), breaking through ice (3), and intentional submersion (2). Twelve animals were found submerged in water with unclear surrounding circumstances. Treatment included administration of supplemental oxygen, antimicrobials, furosemide, corticosteroids, and aminophylline and assisted ventilation. Respiratory dysfunction was detected in 21 animals. Neurologic dysfunction was detected in 12 animals, hepatocellular compromise was detected in 6 animals, and cardiovascular dysfunction was detected in 4 animals. Three dogs had hematologic dysfunction, and 2 dogs had acute renal dysfunction. Eighteen (64%) animals survived to hospital discharge, but all of the cats died. In 9 of 10 nonsurvivors, respiratory tract failure was the cause of death or reason for euthanasia.

Conclusions and Clinical Relevance—Results suggest that submersion is an uncommon reason for veterinary evaluation but is associated with a good prognosis in dogs in the absence of respiratory tract failure.

Contributor Notes

Presented in part in abstract form at the 12th International Veterinary Emergency and Critical Care Symposium, San Antonio, Tex, September 2006.

Address correspondence to Dr. Rozanski.